~Dual Comp Staff Provider Onboarding Binder 06.26.20

HEALTH SAVINGS ACCOUNT VISA CARD FROM HealthEquity MONEY DEPOSITED IN TO ACCOUNT TO SPEND – UC CONTRIBUTES TO THE ACCOUNT ON A MONTHLY BASIS ; PRO-RATED FOR START DATE – EMPLOYEES CAN CONTRIBUTE ADDITIONAL AMOUNT UP TO IRS LIMIT – $2.95/MONTH BANKING FREE APPLIES – ACCESS TO FUNDS ARE TYPICALLY AVAILABLE THE FIRST FULL MONTH FOLLOWING BENEFITS ENROLLMENT DEADLINE SPEND ON ELIGIBLE HEALTH CARE EXPENSES – KEEP RECEIPTS; TAX PENALTIES APPLY IF USED INCORRECTLY – TAX DEPENDENTS/SPOUSE CAN USE HSA ELIGIBILITY RULES – ENROLLMENT IN HDHP AT UC – CANNOT BE ENTITLE TO OR ENROLLED IN MEDICARE PART A AND/OR PART B – CANNOT BE COVRED BY A SPOUSES FSA – CANNOT BE COVERED BY ANOTHER MEDICAL PLAN (UNLESS IT IS AN HSA-QUALIFIED PLAN) FLEXIBLE SPENDING ACCOUNT

HEALTH CARE FLEXIBLE SPENDING ACCOUNT – NOT AVAILABLE IF YOU ELECT HDHP MEDICAL PLAN – MINIMUM CONTRIBUTION - $120.00 PER YEAR – MAXIMUM CONTRIBUTION - $2,400.00 PER YEAR DEPENDENT DAY CARE FLEXIBLE SPENDING ACCOUNT – MINIMUM CONTRIBUTION - $120.00 PER YEAR – MAXIMUM CONTRIBUTION PER YEAR • SINGLE OR MARRIED, FILING JOINTLY - $5,000.00 PER YEAR • MARRIED, FILING SEPARATELY - $2,500.00 PER YEAR

Medical Insurance 4

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